The Relationship between Allergen-Specific to Total Immunoglobulin E Ratio and Oral Food Challenge Outcome in Patients Sensitized to Cashew and Pistachio
Session Number
Project ID: MEDH 11
Advisor(s)
Dr. Sakina Bajowala; Kaneland Allergy and Asthma Center
Discipline
Medical and Health Sciences
Start Date
19-4-2023 9:05 AM
End Date
19-4-2023 9:20 AM
Abstract
Oral food challenges (OFC) are the gold-standard method to confirm the diagnosis of food allergies but entail a risk of inducing allergic reactions. To more accurately identify which patients are likely to successfully complete an OFC, researchers have calculated optimal allergen-specific/total IgE ratios for various food types. If this sIgE/tIgE ratio is less than the cutoff value, the patient is highly likely to pass an OFC. When using the recommended sIgE/tIgE ratio cutoff for pistachios and cashews, allergists have noted a higher-than-expected number of failed OFCs. To investigate whether a different sIgE/tIgE ratio might better predict the outcome of cashew or pistachio OFC, we conducted a retrospective chart review of patients who underwent cashew or pistachio OFC in a private allergy clinic from 2020 through 2022. Our analysis of 38 OFCs revealed that the median sIgE/tIgE ratios for failed and successful pistachio OFC were similar (0.28% vs. 0.29%), and the ratios for failed and successful cashew OFC were 0.28% vs. 0.14%. However, with a p-value of 0.055, the difference in ratio between the failed and successful cashew OFC groups was not statistically significant.
The Relationship between Allergen-Specific to Total Immunoglobulin E Ratio and Oral Food Challenge Outcome in Patients Sensitized to Cashew and Pistachio
Oral food challenges (OFC) are the gold-standard method to confirm the diagnosis of food allergies but entail a risk of inducing allergic reactions. To more accurately identify which patients are likely to successfully complete an OFC, researchers have calculated optimal allergen-specific/total IgE ratios for various food types. If this sIgE/tIgE ratio is less than the cutoff value, the patient is highly likely to pass an OFC. When using the recommended sIgE/tIgE ratio cutoff for pistachios and cashews, allergists have noted a higher-than-expected number of failed OFCs. To investigate whether a different sIgE/tIgE ratio might better predict the outcome of cashew or pistachio OFC, we conducted a retrospective chart review of patients who underwent cashew or pistachio OFC in a private allergy clinic from 2020 through 2022. Our analysis of 38 OFCs revealed that the median sIgE/tIgE ratios for failed and successful pistachio OFC were similar (0.28% vs. 0.29%), and the ratios for failed and successful cashew OFC were 0.28% vs. 0.14%. However, with a p-value of 0.055, the difference in ratio between the failed and successful cashew OFC groups was not statistically significant.